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Early inflammatory profiling identifies patients at risk for persistent pulmonary dysfunction after COVID-19: a
Felipe Dal-Pizzol1, Rafaella de Carvalho Caetano2, Laene de Souza Ribeiro2
1Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina, Criciúma, SC, Brazil; National Institute of Science and Technology Precision Medicine in Intensive Care, Criciúma, SC, Brazil; Intensive Care Unit, Hospital São José, Criciúma, SC, Brazil.
Heart & Lung : the Journal of Critical Care
|July 31, 2026
Summary
Identifying early inflammatory profiles in COVID-19 patients can predict long-term lung function. This helps tailor follow-up strategies for better respiratory recovery and personalized medicine approaches.
Area of Science:
- Pulmonary Medicine
- Critical Care Medicine
- Immunology
Background:
- Limited evidence exists on long-term pulmonary outcomes post-COVID-19.
- This hinders the development of effective patient follow-up strategies.
Purpose of the Study:
- To identify patients at risk of persistent pulmonary impairment after COVID-19.
- To utilize clinical and inflammatory profiles for individualized follow-up and precision medicine.
Main Methods:
- Prospective cohort study of hospitalized COVID-19 adults.
- Inflammatory profiling using a 65-plex biomarker panel within 24 hours of ICU admission.
- K-means clustering identified distinct inflammatory phenotypes (ThHigh and ThLow).
- Pulmonary function (DLCO, TLC, FEV1, MIP) assessed at 6 and 12 months.
- Linear mixed models identified predictors of long-term outcomes.
Main Results:
- Two inflammatory phenotypes identified: high-inflammatory (ThHigh) and low-inflammatory (ThLow).
- ThHigh group showed significantly higher DLCO (β = 9.44) at 12 months.
- ThHigh group exhibited significantly lower FEV1 (β = -4.05) at 12 months.
- No significant associations found between phenotypes and TLC or MIP.
Conclusions:
- Early inflammatory phenotypes in COVID-19 correlate with distinct long-term pulmonary recovery patterns.
- Supports early risk stratification to identify patients with persistent respiratory dysfunction.
- Facilitates personalized follow-up strategies and precision medicine for post-COVID-19 respiratory care.
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